| Note: Although confusingly similar, the term "fat preservation lower blepharoplasty" is sometimes used to indicate repositioning of lower orbital fat onto the upper cheek, a procedure we no longer recommend.
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devoted entirely to Tissue Sparing Blepharoplasty
• Primary goal: Reduction of lower eyelid fat bulging
• Secondary goals: Avoidance of long-term hollowness
• Anesthesia: Local anesthesia with oral or intravenous sedation
• Operative technique: Tissue-Sparing Lower Blepharoplasty - Technique
• Variations: A number of variations have been proposed, including use of a conjunctival (rather than skin) incision and use of the orbital septal (rather than the capsulopalpebral fascia) to repair the fat hernia. We have tried all variations and prefer a skin approach with repair of the fat hernia using the capsulopalpebral fascia rather than the orbital septum.
• Advantages: Still theoretical rather than proven. See Tissue-Sparing Lower Blepharoplasty - Advantages
• Care and recovery: As noted in Section Four
• Risks and complications: As in Chapter 28: Eyelid Surgery Risks and Complications.
• Comment: Although not free of potential serious problems, lower eyelid tissue-sparing may pan out as an alternative approach to current forms of blepharoplasty. Still developmental, safety and long-term effectiveness are under study. We employ the technique sparingly and have gradually come to question the validity of its main premise.
Chart: Comparison of the three main types of lower blepharoplasty
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Reinforcement at the Lateral Canthus
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